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Since stem cell therapy for erectile dysfunction

Since stem cell therapy for erectile dysfunction (ED) is a relatively new and high-tech area with different protocols (e.g., autologous cells derived from adipose tissue or bone marrow), I need to understand the actual proven efficacy of this method compared to proven standard methods such as PDE5 inhibitors or surgery, especially for patients with severe ED caused by diabetes, prostatectomy, or vascular disease. What specific clinical evidence and long-term results (e.g., 5-year follow-up data on IIEF-5 scores) have been published by leading German urological centers offering this procedure, and are there clear criteria for selecting patients in whom stem cell treatment is guaranteed to yield a positive result and not a waste of time and money? Furthermore, given that such procedures can be expensive, what is the total financial burden to expect for the entire treatment package, including the collection of material, laboratory preparation of cells, the actual injection procedure, and the necessary post-procedural monitoring, and are there any safety risks (e.g., risk of infection, rejection, or tumor formation) that are discussed in detail with the patient prior to therapy?